Professional and lay care in the Tanzanian village of Ilembula

The purpose of this ethnographic study is to describe and analyse professional and lay care in the Bena cultural context in the Tanzanian village of Ilembula. The study focuses on care as a cultural phenomenon. The structure of the study is based on M.M. Leininger's (1991) Culture Care Theory In the first phase of the study, care was described from a professional perspective. The data were collected by interviewing and observing trained nurses (n=6) in the wards of Ilembula Lutheran Hospital. The study material was complemented with the data obtained from informants' diaries and institutional documents. The data were analysed by using qualitative ethnonursing analysis. In the second phase of the study, the focus was on lay care. The fieldwork was done in the Ilembula village and Ilembula Lutheran Hospital. The data were collected by interviewing villagers (n=49) and relatives (n=12) of patients admitted to Ilembula Lutheran Hospital, and by observing their care practices. The data were analysed by qualitative content analyses with regard to the cultural context. Curing and caring were the characteristics of professional care, as described by the nurse informants. Curing was linked to skills and knowledge obtained in nurse training and it was demonstrated through technical interventions, medication and health education. Caring referred to a natural mother-child relationship and reflected the traditional cultural knowledge. Caring was demonstrated in primary care, meaning a mother's responsibilities in taking care of a small baby, encouragement and comfort. The patient's recovery and maintenance of health were the goals of professional care. Respect and protection were the characteristics of lay care, reflecting the worldview and cultural values of the Bena. The aim of respect was to maintain family unity and to ensure wellbeing, while protection focused on the sensitive phases of the Bena life span. The main meaning of lay care for the informants was health maintenance and improvement of health. Health included physical, mental and reproductive aspects, and enabled them to respond to the culturally determined role expectations. The aim of this ethnographic study was to demonstrate that care is integral to much more comprehensive socio-cultural issues in the context of a Tanzanian village. The study demonstrates the meaning of cultural and social factors, such as cultural values and lifeways, kinship, economic, educational, and ethnohistory in both professional and lay care. The findings can be utilised in transcultural nursing education and in clinical nursing practice, especially in developing patient education from a transcultural perspective, not only in Tanzania, but internationally.